Objective To find a new operation based on the themy of NOTES,through the way of mouth floor-pretracheal space-retrosternal space,instead of through esophagus or the trachea.Methods We anesthetized six mongrel dogs with endotracheal intubation,then cut the tissue between the incisors and the glossodesmus.The retrosternal space was separated slowly by the balloon expander,and cut the right mediastinal fascia,and went through thorax,then cut a small piece of lung tissue,which would be used to biopsied.Results All of the 6 operations were successfully completed,without any arrhythmia,serious bleeding,airway obstruction and death.Conclusion It doesn't need the soft endoscope in the new operation,which will have bigger operating space and to be safer,just with pin type thoracoscope and related apparatus.

Objective To evaluate the role of thoracoscopy-assisted mini-incision in surgical treatment of lung tuberculosis.Methods From 1999 to 2004,pulmonary lobectomy was performed with thoracoscopy-assisted mini-incision(5-7 cm) on 42 patients with lung tuberculosis(right superior lobectomy in 16,right middle lobectomy in 4,right inferior lobectomy in 4,left superior lobectomy in 10,left lingular lobectomy in 4,and left inferior lobectomy in 4).Results None of the patients were converted to open surgery.The mean operation time was 105 min(35-170 min);blood loss ranged 100-800 ml(mean,150 ml).In the patients,thoracic drainage lasted for 1-5 d(mean,2.8 d) after the operation,and the hospital stay was 4-11 d(mean,6.7 d).During a 2-to 13-month follow-up(mean,8.2),no patient showed positive sputum,bronchopleural fistula,or diffusion of tuberculosis.Conclusions Since thoracoscopy-assisted mini-incision is assosiated with minimal tissue injury,few blood loss,quick postoperative recovery,short hospital stay,and few complications after the surgical treatment of lung tuberculosis,it is worth being widely used.For surgeons,it is important to remember the indications for the procedure.

20 years)was 8.60%(48/558) , which was more than that in the second decade of life ( 5.22% ). The incidence of painful group was 9.79%(14/143),which was more than that in foot trauma group 6.78%(40/630).The positive C sign was presented in 61.1%(33/54),posterior-type coalition in 38.9%(21/54),short talar neck sign in 61.1%(33/54)and talar beak sign in 22.2%(12/54). Conclusion The talocalcaneal coalition is a common development abnormality in our country. We must pay attention to the diagnosis of talocalcaneal coalition for painful foot adulthood.

Objective To study the incidence and radiologic findings of calcaneonavicular coalition.Methods CR films of foot andankle in 1361 cases were presented,which were evaluated for acute trauma or chronic pain.There were 588 cases of foot CR and 773 cases of ankle CR,age ranged from 10 years to 91 years(984 cases of 20~40 years).The prevalence of calcaneonavicular coalition was determined and the different significance of both male and female,acute trauma and chronic pain group were analysed.Results In 1361 cases,72 cases of calcaneonavicular coalition(5.3%) were demonstrated,8.7%(47/588)on foot CR films and 3.2%(25/773) on ankle CR films.Calcaneonavicular coalition was more dipicted on foot CR films than on ankle CR films(P0.05).Conclusion The foot CR films is more superexcellent than the ankle CR films on demonstrating calcaneonavicular coalition.

Objective To study the clinicoradiologic significance of C sign.Methods 773 cases of standard ankle CR radiographs were presented for diagnosis of acute trauma and ankle pain. There were 565 males and 208 females, ages ranged from 10 to 81. There were 630 cases of acute trauma and 143 cases of painful ankle. C sign incidence, C sign figuration, distance of the medial facet of talocalcaneal joint, and the figuration of sustentaculum tali were studied. The relationship between C sign and talocalcaneal coalition was analysed.Results The incidence of C sign was 54.6%(422/773). The female incidence was 61.1%(127/208) ,which was more than that of male(52.2%,295/565)(P

Objective To investigate the problems during using, standard and quality management of the POCT glucose meters in hospital, to analyze the solutions, and to provide reference data for improving the test level of POCT in hospital.Methods The amount, brand and application of portable glucose meters in the hospital were obtained by 3 rounds of surveillance from May to July in 2013.All of those glucose meters were taken part in external quality assessment of Clinical Laboratory Center of National Health and Family Planning Commission.The test results of those glucose meters were compared with that of automatic biochemical analyzer, the comparison results were then analyzed.Results The POCT glucose meters possessed 5 brands in our hospital, and the amount and type of glucose meters in some clinical departments were often changed.When 4 brands which were detected as quality control samples by ministry of health, the accuracy of detection results of 3 concentration of brand Ⅲ were substandard, the CV% of two levels were 11.9%and 10.1%respectively, the remaining 3 brands were in line with the requirements.The qualified percentages of 3 times of comparison were 85.0%, 92.0%and 97.4%.Conclusions The hospital should select the brand of portable glucose meters reasonably, correct use of glucose meters, and it is very necessary to build indoor and interstitial quality evaluation system, at the same time, suggesting the hospital to establish the POCT quality management team, to carry out the instrument comparison periodically, so to guarantee the accurate, reliable results of POCT in hospital.

Objective To explore the correlation between 5-LO,Hcy and the stability of carotid artery arteriosclerosis (CAS).Methods A total of 176 patients diagnosis as CAS were assigned as study group then subdivided into stable plaques SP (group) and instable plaques IP(group).108 healthy volunteers were assigned as control group.The serum levels of 5-LO and Hcy were measured and the relationship between the two groups were analyzed.The risk factors of CAS were investigated by Logistic regression analysis and 5-LO and Hcy were used to predict the stability of carotid atherosclerotic plaque by drawing ROC curve.Results The levels of 5-LO and Hcy in the IP group were higher than those in the SP group and the control group(P＜0.05).The level of Hcy in SP group was higher than that in the control group (P＜0.05),while there is no statistical significance between SP and control group in the level of serum 5-LO(P＞0.05).Logistic regression analysis showed that 5-LO,Hcy and diabetes were the risk factors of CAS (P＜0.05).The ROC curve indicate that the optimal cut-off concentration of 5-LO was 232.89 pg/mL for discriminating the IP from SP,the sensibility and specificity were 84.4％ and 81.8％ respectively.And the optimal cut-off concentration of Hcy was 12.53 μmol/L and the sensibility and specificity were 70.1％ and 66.7％ respectively.Conclusion Serum 5-LO and Hcy are risk factors for predicting the stability of CAS plaques;regulating both levels may be a potential target for clinically stable CAS.

Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; Humans ; Lung Neoplasms ; pathology ; surgery ; Prognosis ; Thoracic Surgery, Video-Assisted

Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.